| NPI | 1861046393 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L10393)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR A5224)  | 
| Enumeration Date | 2019-08-01 | 
| Last Update Date | 2022-01-01 |